Effects of early corticosteroid use in patients with severe coronavirus disease 2019

BMC Infectious Diseases

Heun Choi¹  Eun Jin Kim²  Ji-Hyeon Baek³  Mi Young Ahn⁴  Jung Ho Kim⁵  Moo Hyun Kim⁵  Joon Sup Yeom⁵  Yunsuk Cho⁵  Jun Yong Choi⁵  Jin Young Ahn⁵  Yae Jee Baek⁵  Jong Hoon Hyun⁵  Su Jin Jeong⁵  Yujin Sohn⁵  Young Keun Kim⁶ 

[1] Department of Infectious Disease, National Health Insurance Service Ilsan Hospital, Goyang, South Korea;Department of Infectious Diseases, Ajou University School of Medicine, Suwon, South Korea;Department of Internal Medicine, Inha University School of Medicine, Incheon, South Korea;Department of Internal Medicine, Seoul Medical Center, Seoul, South Korea;Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, 03722, Seoul, South Korea;Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea;

关键词: Coronavirus disease 2019;    COVID-19;    SARS-CoV-2;    Pneumonia;    Corticosteroid;   

DOI  :  10.1186/s12879-021-06221-5

来源: Springer

【 摘 要 】

BackgroundCoronavirus disease 2019 (COVID-19) is associated with acute respiratory distress syndrome, and corticosteroids have been considered as possible therapeutic agents for this disease. However, there is limited literature on the appropriate timing of corticosteroid administration to obtain the best possible patient outcomes.MethodsThis was a retrospective cohort study including patients with severe COVID-19 who received corticosteroid treatment from March 2 to June 30, 2020 in seven tertiary hospitals in South Korea. We analyzed the patient demographics, characteristics, and clinical outcomes according to the timing of steroid use. Twenty-two patients with severe COVID-19 were enrolled, and they were all treated with corticosteroids.ResultsOf the 22 patients who received corticosteroids, 12 patients (55%) were treated within 10 days from diagnosis. There was no significant difference in the baseline characteristics. The initial PaO2/FiO2 ratio was 168.75. The overall case fatality rate was 25%. The mean time from diagnosis to steroid use was 4.08 days and the treatment duration was 14 days in the early use group, while those in the late use group were 12.80 days and 18.50 days, respectively. The PaO2/FiO2 ratio, C-reactive protein level, and cycle threshold value improved over time in both groups. In the early use group, the time from onset of symptoms to discharge (32.4 days vs. 60.0 days, P = 0.030), time from diagnosis to discharge (27.8 days vs. 57.4 days, P = 0.024), and hospital stay (26.0 days vs. 53.9 days, P = 0.033) were shortened.ConclusionsAmong patients with severe COVID-19, early use of corticosteroids showed favorable clinical outcomes which were related to a reduction in the length of hospital stay.

【 授权许可】

CC BY